Analysis Of Factors Associated With Spleen Deficiency Syndrome And Clinicopathological Features After Radical Surgery For Colorectal Cancer

ObjectiveTo investigate the distribution of syndrome differentiation of spleen deficiency syndrome in colorectal cancer(CRC)patients after radical resection,and to explore relevant factors influencing the onset of postoperative spleen deficiency syndrome.We aim to provide references for postoperative syndrome differentiation of spleen deficiency syndrome in CRC patients,and to guide medications.MethodsA total of 243 CRC patients undergoing radical resection in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from February 2018 to September 2020 were retrospectively analyzed.Baseline characteristics(sex,age,BMI,family history,smoking history,drinking history,preoperative neoadjuvant therapy,surgical method and preoperative intestinal obstruction or perforation),and pathological data(tumor location,pathological subtype,TNM staging,nerve or vascular invasion and expression of MMR protein)of them were collected in the medical record database.Based on the diagnosis of spleen deficiency syndrome,CRC patients were categorized into spleen deficiency syndrome group and non-spleen deficiency syndrome group.SPSS was used for data processing.Chisquare test,independent-sample Student’s t test and Mann-Whitney U test were used properly.Logistic regression analysis was performed to investigate independent risk factors influencing the incidence of spleen deficiency syndrome in CRC patients after radical resection.ResultsThe incidence of spleen deficiency syndrome in 243 recruited CRC patients was 32.9%.The average age was older in spleen deficiency syndrome group than that of non-spleen deficiency syndrome group.There was a significant difference in the age distribution of CRC patients between groups(P<0.05),manifesting as higher incidence of postoperative spleen deficiency syndrome in middle-aged and elderly patients with CRC.Female CRC patients presented higher incidence of spleen deficiency syndrome than that of males,although the difference was not statistically significant(37.72% vs.28.68%,P>0.05).Female CRC patients with postoperative spleen deficiency syndrome were significantly older than female ones with non-spleen deficiency syndrome(P<0.05).In addition,the incidence of spleen deficiency syndrome in different locations of CRC ranged from right hemicolon(44.62%),left hemicolon(32.73%)and rectum(22.06%).There was significant difference in the distribution of spleen deficiency syndrome in CRC patients(P<0.05).BMI,TNM staging,nerve or vascular invasion,preoperative intestinal obstruction or perforation and expression of MMR protein were not correlated to the incidence of postoperative spleen deficiency syndrome in CRC patients(P>0.05).After introducing age,sex,BMI,smoking history,drinking history,tumor location,nerve or vascular invasion,preoperative intestinal obstruction or perforation,expression of MMR protein and family history into the Logistic regression model as independent variables,it is found that there was no significant difference between the above factors and the risk of spleen deficiency syndrome(P>0.05).ConclusionThe incidence of spleen deficiency syndrome in CRC patients is about 33%,serving as a vital TCM syndrome.Age,sex and tumor location of CRC patients are correlated to the postoperative spleen deficiency syndrome.In particular,middle-aged and elderly,females and CRC in the right hemicolon are more prone to spleen deficiency syndrome.However,the incidence of spleen deficiency syndrome is not correlated to BMI,family history,smoking history,drinking history,preoperative neoadjuvant therapy,surgical method,TNM staging and expression of MMR protein.